23% of Disability Claims Processed Incorrectly
Post date: Jun 21, 2011 9:33:34 PM
May 21, 2011 • Ben Krause
In a recent audit of the VA Disability Compensation System at 16 Regional Offices, the VA Office of the Inspector General estimates that the rating staff incorrectly processed 23 percent of the 45,000 claims inspected.
The IG investigated offices throughout the US and focused mainly on the handling of the following five types of claims: 1) extra-schedular 100 percent disability evaluations (TDIU), 2) PTSD, 3) TBI, 4) Herbicide Exposure, and 5) Haas (Haas v Nicholson: “blue water” claims from Vietnam Agent Orange exposure). The processes evaluated ranged from mail handling to actual disability percentage awards.
Of the 16 Regional Offices, Baltimore, MD and Anchorage, AK scored the lowest in compliance with VA standards. Both failed to meet 14 of the 15 process requirements. Extended management vacancies were cited as one of the linking factors between all poorly performing Regional Offices. Because of the vacancies, these offices lacked continuity and proper oversight. As a result, procedures were not developed or implemented to correct previously identified problems.
The Haas vs. Nicholson claims had the highest rate of error. In January, the VA released a report claiming the TDIU errors would have resulted in an overpayment of over $1.1 billion by 2016. While this may be true, the VA made no effort to project the amount of dollars not paid to incorrectly denied veterans who would otherwise have qualified. It’s quite possible that this amount might be much higher in the other direction.
Meanwhile, at 83 percent of the Regional Offices, Haas claims had a higher instance of the VA failing to follow VA policy (5 of 6 surveyed failed the standard). Haas claims involve veterans who were likely exposed to Agent Orange but never set foot in Vietnam. Prior to the 2006 Haas v Nicholson decision, mainly veterans who set foot on Vietnamese soil or road on craft up rivers in Vietnam were entitled to the presumption of exposure. Now, the VA is still attempting to catch up to the claims backlog that was caused by the VA appeal of that 2006 decision. In 2009, the decision for Haas was upheld and the VA has since struggled to maintain continuity between offices in how the backlogged claims are processed. The report stated some of these claims were incorrectly denied after the initial Haas decision was upheld.
Veterans receiving denials or low-ball ratings within the past year for any disability ratings may want to consider immediately looking over their decision and request a copy of their VA claim file. If the time passed since the decision is close to the 12-month appeal deadline, contact your Veteran Service Officer to discuss the possibility of appealing it, if warranted. There are both “for pay” and Pro Bono VSO’s. I suggest talking to the Pro Bono people first. Try to find one you trust who will handle your claim in a professional manner.
Veterans already denied at the Board of Appeals review may want to consider speaking with a Veterans Law Attorney in their area, since VSO’s cannot represent veterans before the US Court of Appeals for Veterans Claims. Two resources worth looking at are the National Organization of Veterans Advocates (NOVA) and National Veterans Legal Services Program (NVLS). There are many other attorneys out there as well. A simple Google search could render quality results as well. Just be sure the lawyer is accredited by the Department of Veterans Affairs. Of course, confident veterans can always opt to represent themselves Pro Se before the court, as well.